How mindfulness helps prevent addiction relapse

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Doug McCaslin, an attendee of the Mindfulness Based Relapse Prevention program at St. Joseph's Health Centre.

Two years ago, Doug McCaslin was leading a double life. The 65-year-old was splitting his time between his home in Toronto and a job in Ottawa – a contract gig where he was making “pretty decent money” and living out of a hotel suite. When he’d get off work during the week, there was no wife to come home to, no dog to walk. So he’d drink.“My way of relaxing was drinking,” says McCaslin, reflecting on his years of alcohol abuse. “It came to the point where, if given the opportunity… I’d try to relax 24/7.”

His coworkers noticed. And his boss.

“We’ve rethought your role in the project and we’ve terminated your contract early,” McCaslin recalls being told. “I kind of rationalized it that I was paid for the time I was there.” If he didn’t come to the office – because he’d gone drinking – then he simply wasn’t paid, and that was his choice, right?

“I got let go because I was drunk too much, and not showing up for work,” he says, bluntly.

McCaslin talks about his prior drinking habits with evident self-reflection. He has a different perspective now, one that’s rooted in an ancient Buddhist practice now being applied in modern healthcare: #Mindfulness.

McCaslin is telling his story in a St. Joseph’s Health Centre meeting room, where he’s just wrapped up another weekly Mindfulness Based Relapse Prevention meeting. The meetings bring together people who are dealing with various addictive behaviors – alcohol, drugs, gambling, among others. McCaslin first came to St. Joe’s for substance abuse treatment in May 2012, and has since explored mindfulness both on his own and within the group sessions.

“(Mindfulness is) about creating awareness in the present moment, and being non-judgmental,” explains Linda Picken, Coordinator of St. Joe’s Withdrawal Management Service and one of several staff members who spearheaded the hospital’s Mindfulness Based Relapse Prevention program.

So far, around 60 clients have attended sessions since it launched in 2013. The 10-week aftercare program provides these participants – who’ve typically received prior treatment at St. Joe’s – with relapse-prevention skills and mindfulness meditation practice. They’re taught how to use mindfulness in their everyday lives to prevent a relapse back into their old habits, with a focus on long-term, real-world relapse prevention. McCaslin says the practice gives people the tools to pull back and consider situations, rather than acting on impulse.

“If you asked me to tell you what to do in two words, it would be ‘just breathe,’” he says. “You use the breathing to calm the mind.”

It sounds like common sense. But consider this: How often are you truly focusing on just one thing? If you’re driving a car, you’re driving – and listening to music, and making a mental to-do list, and having a conversation, and trying to figure out what to cook for dinner, and probably not really thinking much about driving at all.

“If you’re eating, eat. If you’re driving, drive. If you’re walking, walk. But most of us, our minds are off doing other things. We’re all distracted,” says McCaslin.

For people dealing with substance abuse, the practice of mindfulness helps them shift gears. “If you can sit and calm yourself, you won’t get rid of the thoughts – thoughts will come – but it’ll be like a leaf floating down a stream,” says McCaslin. “It’ll go by. You’ll watch it go.”

It doesn’t cure the addiction itself, notes Dr. Ty Turner, “but it helps people disengage from the behavior.” Turner is St. Joe’s Lead Psychiatrist in Concurrent Disorders, a field which focuses on patients whose addictions combine with mental health issues. He’s an advocate of mindfulness, and stresses that its applications within modern healthcare are rooted in both ancient traditions and modern scientific evidence.

Turner and Picken were among the four St. Joe’s staff members who attended mindfulness training in April 2013 and launched the relapse prevention program shortly after.

For McCaslin, mindfulness has played a huge role in helping him overcome his reliance on alcohol. He’d previously been afraid of withdrawal, and didn’t feel he could quit drinking on his own while working. “I tried many times to slow down, stop, whatever – but it didn’t work.”

Losing his job was the final push he needed to seek help. “First thing I did after it happened was order up a whole lot of beer and get drunk for a week,” he says. “Then I had to break the news to my wife and head home.”

But that was the old McCaslin. It was a knee-jerk reaction, the sort of decision he used to make before bringing mindfulness into his day-to-day life. He sees things differently now.

These days, McCaslin is semi-retired. There’s no more bouncing around between cities, which gives him more time to spend at home in Toronto with his wife. He’s taking recovery seriously and tries to focus on truly living in the moment, in all the little things – whether he’s driving a car or walking his dog.

“I think before I was part of the madness,” McCaslin explains. “Whereas now, when needed, I can step back an inch and a half from the madness and look at it.”